PM Transcripts

PM:What the Government is working on, based on the recommendations of the National Health Reform Commission is the biggest set of reforms to the health and hospital system since Medicare. This, therefore, requires the Government to work through the recommendations in a calm and methodical way, because we need to make sure that the decisions which are taken by Government on this are right.We are determined, because of the importance of the system to every working Australian, that we get these decisions right.That's why it's been important for us to be here today at Royal North Shore Hospital in Sydney to hear first hand from those who work in the field, from specialists, from doctors, from general practitioners, from nurses and from others in the community care sector, about their experiences here, their initial response to the Commission's recommendations. And, I've got to say, I have learnt a number of things from being here this morning.This will be the first of many all around the country. You've seen on our list of scheduled visits, that the Government proposes to engage with 20 or 25 of the major public hospitals directly around the country. I'll be doing a lot of that myself, and we'll also be engaging other health professional associations as well as those in the community health sector.Big reform, the biggest set of health and hospital reforms since Medicare. That's why the Government's got to consult the community to get it absolutely right.Over to you, folks.JOURNALIST: How about regional and rural hospitals? Do you plan on having forums there as well?PM: Yeah, as you would have seen, or may not have seen, in the speech I gave yesterday, the major public hospitals, obviously, we will be consulting directly with them, a representative group of regional and rural hospitals, and private hospitals as well, together with the health professional associations. There are 750 public hospitals across the country. Therefore we have got to make sure we are engaging properly with the big ones, but also a representative group of the smaller ones, particularly given the findings of the Commission's report about the fact that health outcomes are often worse in regional and rural Australia than they are in the big cities.JOURNALIST: Prime Minister, how much do you feel that Royal North Shore Hospital encapsulates what needs to be done in Australia's health system?PM: The beginning of wisdom is to know what you don't know. And the reason we are consulting across 20 or 25 of the large public hospitals across the country is to begin testing the report's recommendations with those who are practitioners in the field. A good and informed set of responses to us here at Royal North Shore today. Tomorrow I'll be in Adelaide and I'll be talking with a different group down there.Ask me that question at the end of the process and I'll probably give you a more considered response.JOURNALIST: (inaudible)PM: Well, I'm in Sydney, and I had to be in Sydney last night, so we thought it was useful to come here because obviously there are challenges right across the hospital system in the country, but we want to be upfront in tackling problems where they exist and where the public has concluded they exist, and then engage in a very practical way about how we can improve it in the future.We are not faintly interested in perpetuating the politics of the blame game. The country has had a gutful of that. What they want us to do is get on with the job of saying ‘how can we take this health system across the nation and improve it from here to here, and how much will that cost, and how can we go about implementing it rationally over time?'JOURNALIST: Prime Minister, you don't see the hospital system as broken?PM: What the report of the National Health Reform Commission tells us is that the hospital system and the health system across Australia is reaching a tipping point. That's the term they use. You put together all the pressure factors: ageing population, the increase in the cost of medical interventions, the increasing cost of pharmaceuticals, the explosion in chronic diseases in all the categories. All that happening at one end of the spectrum.Challenges with workforce and proper national long-term planning for nurses, doctors and bringing people through the system and a proper geographical spread of them.And thirdly, using the taxpayer dollar better across prevention, primary care and acute care and post-acute care to make sure that it works.Now, what the Commission has concluded is: ‘look, the time for fiddling around the edges is rapidly drawing to a close. There is a tipping point being reached here.' That's why they put forward the largest set of proposed reforms for the health and hospital system since Medicare. So our job is to grab this with both hands and have a go, and we intend to.JOURNALIST: You wanted to engage Australians on this health conversation and discussion and go forward from here, but it seems that the cost and costings need to be more upfront than they are now. At the moment you're saying that the Henry Review of Taxation will give us all a better picture about where revenue is going to come from, but don't Australians, at this point in the conversation need to know more about what it will cost us in the future?PM: Well, actually the Commission's report itself has two to three sets of conclusions about cost to the additions to the system which are proposed.One is the additional annual recurrent cost which, depending on where you land, is between $2.8 billion and $5.4 billion, or thereabouts, recurrent per annum. Secondly, an additional set of one-up capital costs. And thirdly, specific costs in terms of Denticare, if the Government proceeds in that direction.They are outlined in the report.Secondly, what we've got to do, and I canvassed this, I think, yesterday in my remarks in Canberra, is now test all of those assumptions with Treasury data as well.Third thing we need to do is mesh that with the upcoming data we're going to get from the next version of the intergeneration report on the ageing of the population and where that is going in terms of long-term demand, particularly in terms of age care.It's not easy. It's complex. But let me tell you, I'll be seeking to emphasize throughout is here are the reforms which are being recommended to us, and for the country at large to know that none of these come for free. Way of funding them I referred to in my remarks earlier today. Transfers between the states and the Commonwealth, one. Two, efficiencies in the system, particularly off the back of the health reforms. And three, from the revenue.All these things related to each other.I just want to be frank about the fact that the system has reached a tipping point. We need some fundamental, long-term reforms, and it's going to cost.JOURNALIST: The American Chuck Feeney has made one of the biggest medical donations here in history in Queensland. How much do we need to rely on philanthropy from the corporate world to help fund our medical research and hospitals in the future?PM: Well, can I just publicly congratulate Chuck Feeney for his philanthropy, not just in Queensland but in other parts of Australia as well. One of the first things I did as Prime Minister was invite Chuck to lunch at Kirribilli, just down the road here, to thank him for his extraordinary acts of generosity to the Australian health system, and as I'm advised here, it's $102 million to be allocated across the following projects:
* $50 million towards the $354 million Translational Research Institute at the PA Hospital in Brisbane;
* $27.5 million towards QIMR; and
* $25 million towards QUT's hub for Sustainable and Secure Infrastructure.
These are great acts of generosity on his part and his foundation's part, and we've sought, as the other state governments have done, to be co-investors with it.Your question goes to what is the proper role of government in laying out, let's call it health and medical research infrastructure for the future, as opposed to relying upon acts of private philanthropy. Can I say, what you've seen in the last Commonwealth budget with a $3.2 billion proposed investment from the Minister in 32 capital projects across the health and medical research system of Australia demonstrates where we are moving ourselves, putting our money where our mouth is.We welcome Chuck Feeney's philanthropy. The Australian Government is an active co-investor in the nation's health and medical research infrastructure as well.JOURNALIST: At the last state election, the State Government promised new hospital projects - Northern Beach Hospital, Wagga, Parkes, (inaudible) etc - and the Federal Government didn't fund them and therefore they're not going ahead for the time being. Does that call into question the Federal Government's ability to work with the states in terms of providing hospital projects?PM: Look, as I said before, we're not into the business of rolling out the blame game, and various levels of government will make their commitments in terms of various hospitals off their own bat. It's a matter for them. This Government has been meticulous in honouring our pre-election commitments to the Australian people, one of which was the establishment of this Commission, one of which was to then get on with the business of comprehensive health and hospital care reform. I've got to say, complicating and compounded by the fact that in our 18 months or so in office we've had the worst global economic crisis in three quarters of a century but we're still going to get on with the job. On the specifics of that, Nicola, did you want to add?ROXON: Thank you. Just to say, of course, that, to state the obvious, that the state governments, of course, do continue to be the primary funders of capital infrastructure in health. We made quite clear that we were very excited about our health and hospitals infrastructure fund being able to be used to drive reform, to enhance and provide additional funding for states and territories but also for research institutes and others, so there was no intention for that to replace state funding.Of course, the NSW people did receive benefits from that funding. A large number of projects in NSW, including the cancer care centre and the Nepean Hospital as two of the big projects but really, if the question is about the time line for infrastructure development of state hospitals, those questions need to be put to our state colleagues.JOURNALIST: So what you're saying is that if the people of NSW don't get their hospitals, blame the State Government, not the Federal Government.PM: No, what we're saying is - nice try. Can I say I think the Australian people are absolutely fed up with people playing the blame game. We want to get up, get on with the business of doing the best job possible of fixing the health and hospital system for the long term. It is not easy, it is one of the hardest areas for reform in government.Everyone, all of you here today as journalists, have had some direct contact with the health and hospital system, directly or through your family, and all the folk who'll be reading your newspaper or listening to your radio programs or watching your television news tonight. Therefore, every Australian has a huge interest in us getting these reforms right for the long term.We've put our money where our mouth is in two respects so far prior to any consideration of the implementation of the recommendations contained in this report: One, $3.2 billion capital injection from us at a federal level which historically has not existed from the Commonwealth Government, and the Minister just referred to two specific projects in this part of NSW. Second,the Australian health care agreement. This was framed last year, a $64 billion investment, co-investment with the states and territories, a 50% increase on the previous Australian Healthcare Agreement.The previous Liberal Government actually pulled money out of the system. They took $1 billion out of the public hospital system. We're in the business of putting investment back in to the public hospital system, and I'll just draw people's attention to the fact that when there are tensions in funding concerning various projects around Australia, bear in mind this is coming off an historical base of a Federal Government which said ‘let's blame the states and territories and let's pull money out of their bottom draw, which is what they did.One further point I'd just make on this as well is that, on the question of investments, Mr Dutton today, the health spokesman for the Liberal Party, is proposing a freeze on health funding. Look carefully at what he has said.I notice also, earlier Mr Turnbull has said that in his ideal world every Australian should take out private health insurance, and the Liberals in government ripped a billion out of the public hospital system of the states.Where is Liberal policy now standing? The Liberals, through their health spokesman today are saying that health funding should be frozen from the Australian Government. We don't think that's the right way to go. And their leader has said that in his ideal world, everyone should have private health insurance. There is a very clear difference here between the two approaches.There's another thing which has emerged on dental care as well.ROXON: Yeah, Mr Dutton seems to be having a spectacular day today, because he also has indicated opposition to a universal dental scheme, apparently on the basis that this idea would hurt pensioners. Quite an extraordinary allegation I think from the Liberal Party, when everyone in the community is acutely aware of the gaps in our dental services, and where the....PM: The national broadcasters fallen over. (laughter).... Read the Budget (laughter)ROXON: The Liberal Party is making clear that they oppose fixing problems in our dental system, yet we all know people who cannot afford or cannot access dental services. The Health Reform Commission has proposed a new, universal dental care system but in the interim, the Government has been trying to deliver extra resources to the Commonwealth Dental Health Program, particularly targeted at pensioners, that the Liberal Party has repeatedly blocked in the Senate. So I don't think we can take the Liberal Party seriously when they say that they are opposed to ideas when they would actually help pensioners, help those who are disadvantaged. And to suggest that we put a freeze on health spending until the system is fixed, when they have no ideas themselves of how to fix this system, I think is pretty extraordinary.JOURNALIST: Prime Minister, Newspoll seem to be suggesting that people aren't listening to the (inaudible).PM: Look, I don't comment on opinion polls, I was asked about this morning. Whether for the Government they're up or down, our job is to get on with the job, and I've said that constantly in the period that I've been Prime Minister. A couple of things though emerge in terms of their implications for the Liberal Party. I notice that Tony Abbott's out of the blocks, and Tony Abbott is now saying that the Liberals, come the next election, will be bringing back WorkChoices. Pretty interesting.His comments last night along the lines that what he describes as workplace relations reform is not dead yet, we're back again come the next election, for the Liberals. So the Liberals can't give up their WorkChoices addiction. I think that's something the Australian public would pay attention to. But just to finish the Peter Dutton trifecta before, we mentioned what he'd had to say about freezing hospitals funding. Then there's this extraordinary position of opposition to Denticare as an idea. And then thirdly, what you need actually from the Liberal Party is some consistency of policy. Last month, the Liberal Party health spokesman called on the Government to take public hospitals over.Today, the same spokesman, Mr Dutton, says they're in the process of putting their policy together. Can I just say, you either have a policy or you don't. Last month there policy was ‘take over the hospitals'. This policy is, today's policy is they don't have a policy. So, whether it's on climate change, where the Liberals are divided right down the middle, on health policy we now have about five different positions from five different spokesmen on health policy, they are also divided. I think people would expect better of them, particularly given this debate is so important.JOURNALIST: Prime Minister, Peter Dutton also said this morning that today is the second anniversary of the speech that you made about a two year deadline for the national reform of healthcare. What's your response to that? He says the delay....PM: I'd say twelve years of total inaction by the Liberal Party on health and hospital reform speaks for itself. Secondly, I would say that during those twelve years, not just inaction on reform, but the physical withdrawing of funding from the public hospital system, a billion dollars worth speaks for itself. Thirdly, we said the building block of our long term reform of the health and hospital system of Australia would be based on this report, which we've been here discussing today.And that is the report delivered by Christine Bennett's National Health Reform Commission. This affects so many Australians. They therefore expect us to get it right. It's important, therefore, that there is an informed national debate, now that there are concrete proposals out from the Commission. And that's what we're here to do today. And the second is, we also are obviously going to be mindful of the conclusions of the Henry commission on tax, an intergenerational report in terms of the future demand on the system for aged care and aged care related services. Thirdly though, I think what the people of Australia want is a mature and informed debate about the biggest set of reforms which have been put on the table since Medicare. That's what the Government intends to get on and do. And I've got to zip, because I've got to be on a plane to Adelaide. Bye bye.[ends]